scholarly journals Vascular Access Profile of End Stage Renal Disease Patients on Maintenance Hemodialysis: Experience from a Tertiary Care Center of Bangladesh

2019 ◽  
Vol 7 (1) ◽  
pp. 26-28
Author(s):  
Md Mostarshid Billah ◽  
Md Anisur Rahman ◽  
Muhammad Abdur Rahim ◽  
Tufayel Ahmed Chowdhury ◽  
Md Abdul Latif ◽  
...  
Keyword(s):  
Vascular Access ◽  
Care Center ◽  
Tertiary Care ◽  
Study Participant ◽  
Venous Catheter ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Cross Sectional ◽  
Femoral Catheter ◽  
Av Fistula

Background: A well-functioning vascular access (VA) is essential to provide efficient hemodialysis (HD) therapy. There are 3 main types of access: arterio-venous fistula (AVF), arterio-venous graft (AVG) and central venous catheter (temporary or permanent). The aim of our study was to find vascular access profile of ESRD patients on maintenance hemodialysis in a tertiary care hospital. Methods: This cross-sectional study was carried out in the Department of Nephrology and Dialysis of BIRDEM General Hospital, Dhaka, Bangladesh from November to December, 2015. After taking informed consent from the patients, data were collected from face to face interview and record books of the patients. Results: Total patients were 107, male were 78 (72.9 %) and female were 29 (27.1%). The mean age was 57.3 ± 11.4 (range 32-80) years. Mean duration of CKD was found 5.7 ± 4.2 (range 1-20) years. Maximum dialysis duration was 6.5 years with mean of 1.7 ± 1.3 years. Near two-thirds (68.2%) of the patients were on thrice-weekly dialysis and one-third (31.8%) were on twice-weekly dialysis. The vascular access at initiation of dialysis was temporary catheter in majority (91.6%) of study participant and AV fistula in 8.4% cases. Of temporary catheter one-third (33.7%) were temporary jugular catheter and two-third (66.3%) were temporary femoral catheter. Among jugular catheter 9.1% were left sided catheter and rest (90.9%) were right sided catheter. Among the femoral catheter 70.8% and 29.2% were right and left side respectively. The current vascular access was AV fistula in 90.7%, temporary catheters 4.7%, permanent catheter 3.7% and AVG 0.9% in study patients. Of AVF near one third (29.9%) were radio-cephalic and 70.1% were brachial (62.6% brachio-cephalic, 7.5% brachio-basilic) fistulas. About seventeen percent (16.8%) patients had AVF failure. Conclusion: Temporary dialysis catheters were the most common initial vascular access. Less than one-tenth patients started dialysis with AV fistula. More than two-thirds patients were on thrice weekly dialysis. AV fistula was the most common current vascular access with very small number of permanent catheter and AV graft. Bangladesh Crit Care J March 2019; 7(1): 26-28

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

scholarly journals Acute Intradialytic Complications in End Stage Renal Disease on Maintenance Hemodialysis

2012 ◽  
Vol 52 (187) ◽  
Author(s):  
R K Agrawal ◽  
S Khakurel ◽  
R Hada ◽  
D Shrestha ◽  
A Baral
Keyword(s):  
Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Hemodialysis is the preferred method of treatment for Nepalese patients with End Stage Renal Disease. Despite the technological advances and better understanding of physiology associated with hemodialysis, a number of complications are known to be associated with hemodialysis. This study was undertaken to study the frequency of acute intradialytic complications in patients undergoing hemodialysis. Methods: A cross-sectional study was conducted at Nephrology unit of a tertiary care hospital from 15 June, 2007 to 15 December, 2007. A total of 28 patients were included in the study. Patients with acute renal failure and acute on chronic renal failure were excluded from the study. Results: Total sessions of hemodialysis during the period were 1455. Hypotensive episode were 66 (4.5%) and was the commonest complication and followed by hypertensive episodes were 58 (3.8%). Other problems encountered were transfusion reactions were 23 episodes (1.5%), rigors not related to transfusions were 13 episodes (0.8%), nausea/vomiting were 20 episodes (1.4%), muscle cramps were 12 episodes (0.8%), hypoglycemia were 6 episodes 5(0.4%). Conclusions: The frequency of intradialytic complications is low and many of them are not life threatening. Keywords: complications; end stage renal disease; hemodialysis; hypertension; hypotension.

A study on perception about antenatal care among primigravida attending a tertiary care hospital

2019 ◽  
Vol 9 (1) ◽  
pp. 56
Author(s):  
Priya Somu ◽  
Sakthi Narmatha D.
Keyword(s):  
Mortality Rate ◽  
Antenatal Care ◽  
Care Center ◽  
Tertiary Care ◽  
Infant Mortality Rate ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Health Care Center ◽  
Basic Care

Background: Maternal mortality rate and Infant mortality rate remains high in India when compared to several other countries. Understanding and being aware about the basic care provided during pregnancy is an important factor to make the pregnant woman to utilize the antenatal care. Hence this study was planned to assess the existing knowledge of primi gravid mothers attending the tertiary health care center about the various antenatal care services provided.Methods: This cross-sectional study was conducted among the primi gravid females attending the outpatient department of Obstetrics and Gynecology in Sri Muthukumaran Medical College Hospital and Research Institute, Chennai during months of June 2018 to May 2019. A total of 280 primi gravid mothers were included in the study. Data was collected through one to one interview and analyzed using statistical package for social sciences (SPSS) version 17.Results: In this study 82.9%, 70.4%, 80.7% of the mothers were aware about consumption of IFA tablets, TT injection and adequate ANC visits, respectively. PNDT act was known to 76.1% of the participants. Only 12.5% of the primi mothers were aware about Janani Suraksha Yojna (JSY) scheme and 91.8% of the mothers were aware about Dr. Muthulakshmi Maternity Benefit scheme.Conclusions: Knowledge about ANC services was found to be fair among the primi mothers but not sufficient, which shows the need for the healthcare professionals to educate young woman even from adolescent age itself.

scholarly journals Detection of bla NDM-1 Encoding Imepenemase among the Imipenem-Resistant Gram-Negative Bacilli Isolated from Various Clinical Samples at a Tertiary Care Hospital of Eastern Nepal: A Descriptive Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
S. Gautam ◽  
N. R. Bhattarai ◽  
K. Rai ◽  
A. Poudyal ◽  
B. Khanal
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Clinical Samples ◽  
Care Hospital ◽  
Disc Diffusion ◽  
Diffusion Test ◽  
Cross Sectional ◽  
Gram Negative ◽  
Synergy Test

Background. Carbapenem resistance among Gram-negative isolates caused by the production of the metallo-β-lactamase (MBL) enzyme is being increasingly reported worldwide. One of the newly emerged metallo-β-lactamases is New Delhi metallo-β-lactamase. Data regarding its occurrence in hospital setting and percentage prevalence among different Gram-negative bacterial isolates are lacking in our part. This study has been undertaken for determining the presence of the bla NDM-1 gene among the clinical isolates of imipenem-resistant Gram-negative bacteria in a tertiary care center in Dharan, Nepal. Methods. A total of 75 imipenem-resistant Gram-negative isolates were studied. These were screened for metallo-β-lactamase (MBL) production by phenotypic assays such as double-disc synergy test (DDST) and combined disc diffusion test (CDDT). PCR was performed for the molecular detection of gene NDM-1. Ten-disc method was performed to detect the presence of ESBL, AmpC, carbapenamase, and K1 β-lactamase production. Results. Using the molecular method, bla NDM-1 was detected in 36% of the isolates. Phenotypically, double-disc synergy test (DDST) and combined disc diffusion test (CDST) detected MBL production in 38.7% and 37.3% of the isolates, respectively. Ten-disc method detected ESBL in 26.6% of the isolates, but none of the isolates was found to be AmpC, carbapenamase, and K1 β-lactamase producers. Conclusion. A high percentage of the NDM-1 producer was noted among imipenem-resistant GNB. Apart from performing only antimicrobial sensitivity test, phenotypic and molecular screening should be employed to find out the actual number of metallo-β-lactamase producers and the existence of the resistance gene.

scholarly journals Awareness, attitude and practice of breast feeding among mothers at tertiary care center, Puducherry, India

2019 ◽  
Vol 6 (5) ◽  
pp. 2108
Author(s):  
A. Dharmalingam ◽  
Chandru Bhaskar ◽  
N. S. Raghupathy
Keyword(s):  
Exclusive Breastfeeding ◽  
Nutritive Value ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Obese Women ◽  
Cross Sectional ◽  
Breastfeeding Knowledge ◽  
Knowledge And Practice

Background: The knowledge and practice of exclusive breastfeeding has been prejudiced by demographic, social, cultural, biophysical, and psychosocial factors. About two-thirds of under-five deaths in India are associated with inappropriate infant feeding practices. Objective of this study was to assess the awareness, knowledge and practice of breastfeeding among the mothers attending to the tertiary care institute at Puducherry, India.Methods: This hospital-based, cross-sectional study was carried out among 150 postnatal mothers who attended immunization clinics, post-natal and paediatric wards at the tertiary care hospital at Puducherry collecting data about breastfeeding knowledge and practices using a structured interview.Results: The breastfeeding practices were significantly poorer in terms of initiation, feeding colostrums, timing and frequency of feeding and inclusion of pre-lacteal feeds among obese women compared to the normal weighted mothers. The breastfeeding knowledge and attitude was healthy among the mothers as depicted by the awareness of nutritive value of breast milk by majority (84%) of mothers.Conclusions: The mothers had poor knowledge regarding initiation of breastfeeding and administration of colostrum. There was a positive attitude about exclusive breastfeeding, frequency of feeding and social aspects of breastfeeding.

scholarly journals Tuberculosis among Patients Admitted to the Department of Medicine of a Tertiary Care Center in Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Suman Thapa ◽  
Anupam Bista ◽  
Prashant Subedi ◽  
Aaradhana Adhikari ◽  
Sunil Pokharel
Keyword(s):  
Pulmonary Tuberculosis ◽  
Binary Data ◽  
Care Center ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Tuberculosis has high burden in developing countries like Nepal. This study aims to determine the prevalence of tuberculosis among patients admitted in the department of medicine of a tertiary hospital. Methods: A descriptive cross-sectional study of all the patients admitted to the tertiary care hospital from 1st January 2017 to 31st December 2019 was done. Ethical approval was obtained from Institutional Review Committee (Ref: drs2006181387). Convenience sampling method was used. A descriptive analysis of demographic, clinical and laboratory profile of patients was made using Microsoft Excel version 2016. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 6829 patients admitted to the department of medicine, 209 (3.06%) (2.65-3.47 at 95% CI) patients were diagnosed with tuberculosis. Among them, 147 (70.33%) were males and the mean age was 49.77 years. Pulmonary and extra-pulmonary tuberculosis were present in 153 (73.20%) and 56 (26.79%) patients, respectively. Bacteriological confirmation was limited to 107 (70%) of pulmonary tuberculosis and 3 (5%) of extrapulmonary tuberculosis. Fever was the commonest presentation in 166 (79.42%) followed by cough in 164 (78.46%), anorexia in 108 (51.67%), weight loss 104 (49.76%), and others. Conclusions: The study showed that the prevalence of tuberculosis among admitted patients was higher than national prevalence.

scholarly journals Sexually Transmitted Infections in A Tertiary Hospital of Kathmandu: A Retrospective Study

2021 ◽  
Vol 19 (2) ◽  
pp. 44-48
Author(s):  
Sushil Paudel ◽  
Niraj Parajuli ◽  
Sudip Dahal ◽  
Sudarshan Paudel
Keyword(s):  
Sexually Transmitted Infections ◽  
Care Center ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Level Of Education ◽  
Sexually Transmitted

Introduction: Sexually transmitted infections (STIs) are the diseases that are transmitted by sexual contact if a partner is infected with agent known to cause infection of genitalia. This group of diseases pose a huge public health problem. This study aims to provide an insight on the prevalence of STIs in a tertiary care center dedicated to civil servants. Methods: This is a retrospective cross-sectional study. All patients diagnosed with STI in a dermatology out-patient of Civil Service Hospital, a tertiary care hospital situated in Kathmandu over a period of two years from January 1 2018 to December 30 2019 were included in the study. The diagnosis was made by clinical and laboratory investigations. Results: The total number 157 cases of STIs were enrolled in this study, of which 119 (75.8%) were males and 38(24.2%) were females. The mean age of patients was 27.8±8.8 years, ranging from 15 to 60 years. Seventy three (46.5%) patients were married, while 81 (51.6%) patients were unmarried. Unmarried males were significantly more vulnerable to acquire STIs (p=0.005). Males were having significantly more premarital or extramarital sexual exposures as compared to females (p<0.001). The most common presentation was condyloma acuminata in 84(53.5%) patients. Consistent use of condom was reported only in 3 (2.5%) males and 1 (2.6%) females in this study. No association was noted between the education level attained to the practice of safe sexual methods (p=0.535). Conclusion: The proportion of males was higher than females in our study which might be due to the reluctances of female to see doctor for sexual problems. The level of education did not seem to make people aware of practicing safe sex. Sexual education seems must in all level of education.

scholarly journals A cross-sectional study on asymptomatic bacteriuria among antenatal women attending an urban tertiary health care center in Southern India

2017 ◽  
Vol 6 (10) ◽  
pp. 4522 ◽  
Author(s):  
Priya Paari ◽  
Sindhuja T. P. ◽  
Shanthi Dhinakaran ◽  
Christina Mary P. Paul
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Asymptomatic Bacteriuria ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Health Care Center ◽  
E Coli ◽  
Microbiological Testing ◽  
Significant Bacteriuria

Background: Asymptomatic bacteriuria (ASB) in pregnancy is a treatable risk factor for preterm delivery. India accounts for the highest preterm birth incidence in the world according to the WHO census released in November 2016. This study was aimed at finding the prevalence of asymptomatic bacteriuria, the spectrum of bacteria involved and the susceptibility pattern for the antimicrobials in the antenatal women attending a tertiary care hospital in urban Southern India.Methods: One hundred and eighty ante-natal patients without symptoms of ongoing urinary tract infection were enrolled to this study. Clean midstream urine sample was collected in a wide mouthed container and sample was analyzed by standardized microbiological testing techniques.Results: Out of the 180 ante-natal women included in the study, 11(6.1%) patients were found to have insignificant bacteriuria and 38(21.1%) had a significant bacteriuria. E. coli was the most frequently isolated organism and about 95% of the organisms were sensitive to Nitrofurantoin.Conclusions: More than a fifth of all pregnant women have ASB and E. coli is the most frequent pathogen encountered.

MO1017PSYCHOSOCIAL REPERCUSSIONS AND QUALITY OF LIFE OF CHILDREN UNDERGOING HEMODIALYSIS IN A DEVELOPING COUNTRY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Salma Naouaoui ◽  
Kamal Ahtitich ◽  
Meriem Chettati ◽  
Wafaa Fadili ◽  
Inass Laouad
Keyword(s):  
Quality Of Life ◽  
Tertiary Care ◽  
Life Assessment ◽  
University Hospital ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Cross Sectional ◽  
Daily Life Activities ◽  
Significant Difference

Abstract Background and Aims Despite major advances in the provision of renal replacement therapy, children and adolescents on dialysis frequently have compromised daily life activities and a worse quality of life compared with healthy peers. While these aspects have been studied extensively in affluent countries, data from developing regions are scant. The aim of our study was assessing the psychosocial repercussions and the quality of life (QoL) of children with end stage renal disease (ESRD) undergoing hemodialysis in a Moroccan tertiary care hospital and comparing them with healthy controls. Methods We performed a cross-sectional investigation, at Mohammed VI university hospital of Marrakesh, using parent/child reports of generic module for QoL assessment: PedsQLTM Inventory version 4 for both cases and controls. Disease-specific module: PedsQLTM ESRD version 3 was used for ESRD cases. Twenty-two children on maintenance hemodialysis and 50 controls were enrolled in our study. Results The mean age of the ESRD cases was 11.6 ± 4.7 years (range 4– 18 years) with female predominance (58%). Controls were age- and sex-matched. A statistically significant difference was observed between ESRD cases and controls regarding all aspects of QoL. The total QOL mean score was 51.2 ± 13.6 and 82.8 ± 11.2 among cases and controls, respectively. All individual QoL domains were significantly worse in ESRD cases. Conclusion Our findings showed that the quality of life of children undergoing hemodialysis may be dramatically affected especially in limited-resources countries. And this raises the need to introduce quality of life assessment as a part of pediatric ESRD management.

Perspective of health professionals on hand hygiene in a tertiary care center in Pakistan

2020 ◽  
pp. 1-11
Author(s):  
Attia Bari ◽  
Izza Imran ◽  
Nasir Ali Nawaz ◽  
Rizwana Kamran ◽  
Iqbal Bano ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Care Center ◽  
Tertiary Care ◽  
Subscale Score ◽  
Cross Sectional Study ◽  
Attitude Score ◽  
Care Hospital ◽  
Cross Sectional ◽  
Healthcare Associated ◽  
Knowledge Attitude And Practice

Abstract Objective: To determine the awareness of postgraduate residents and nurses working in a tertiary care hospital about hand hygiene. Method: The cross-sectional study was conducted in October 2018 at The Children’s Hospital and the Institute of Child Health, Lahore, Pakistan, and comprised postgraduate residents and nurses. Data was collected using a 31-item self-administered inventory. Data analysis was done using SPSS 21. Results: Of the 360 subject, 152(%) were postgraduate residents and 208(%) were nurses. Overall score of knowledge 202(56%) was low compared to attitude 260(72%) and practice 283(78.6%). The combined score of all three domains was 245(68%), indicating moderate awareness. Postgraduate residents had significantly better knowledge 98(64%) compared to nurses 104 (50%) (p=0.01), while nurses had better attitude score 159(76.4%) compared to the residents 103(68%) (p<0.05). The practice subscale score was not significantly different between the groups (p>0.05). Conclusion: Both postgraduate residents and nurses showed moderately satisfactory knowledge, attitude and practice towards hand hygiene. Key Words: Hand hygiene, Healthcare-associated infections, Postgraduate residents, Nurses, Knowledge, Practices. Continuous...

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